The insurance company denied his claim for payment of Disability Income on the grounds that the insured did not honestly disclose pertinent information at the time of his application, which would have impacted significantly on the Underwriter’s decision.
The Application Form completed by the insured, included a question which asked “Do any of the Proposed Persons intend to seek medical advice, treatment, or have medical tests done?” The applicant responded, “No” despite the fact that his doctor had told him ten days prior, that he would be required to have some tests done which subsequently proved to be positive.
He sought the advice of the Financial Services Ombudsman who subsequently concurred with the insurance company and advised the complainant accordingly.
The second request by the insured for waiver of premiums due to his disability was granted.
A prospective insured has a duty to disclose honestly all material facts bearing on the risk to be borne by the insurer. Information withheld or not honestly disclosed can lead to a cancellation of the policy.